Critical Thinking (NURS170)

Critical Thinking Model - Attitudes

- 11 attitudes define the central features of a critical thinker & how a successful critical thinker approaches a problem. - Guidelines on how to approach a problem or decision-making situation. - Interpreting, evaluating, & making judgements about the adequacy of various arguments & available data. - Knowing when you need more information, know when information is misleading, & recognizing your own knowledge limits are example of guide decision making.

Critical Thinking

- A continuous process characterized by open-mindedness, continual inquiry, perseverance, combined with willingness to look at each patient situation & determine which identified assumptions are true & relevant. - Recognize an issue exists analyze information, evaluate information, & make conclusions. - Consider what is important in each situation, imagine & explore alternatives, consider ethical principles, & make informed decisions about the care of patients. - Requires cognitives skills & the habit of asking questions, remaining well informed, being honest in facing personal bias, & always being willing to reconsider & think clearly about issues.

Developing Critical Thinking - Concept Mapping

- A visual representation of patient problems & interventions that shows their relationship to one another. - Better to synthesize relevant data about a patient, including assessment data, nursing diagnose, health needs, nursing interventions, & evaluation measures. - See more holistic view of a patient.

Attitudes for Critical Thinking - Humility

- Admit to any limitation in your knowledge & skill. - Admit what they do not know & try to find the knowledge needed to make proper decisions. - Rethink a situation, learn more, & use the new information to form opinions, draw conclusions, & take action.

Levels of Critical Thinking

- Basic - trusts the experts have the right answers for every problem; thinking is concrete & based on a set of rules or principles; accepts diverse opinions & values of experts; one right answers usually exists for each problem. - Complex - separate self from experts; analyze & examine choices more independently; learns that alternative & conflicting solutions exist; willing to consider different options from routine procedures when complex situations develop; become more creative & innovative. - Commitment - anticipates when to make choices without assistance from others & accepts accountability for decisions made; choose an action or belief based on the available alternative & support it; determine results of the decision & determine whether it was appropriate.

Attitudes for Critical Thinking - Responsibility & Accountability

- Correctly performing nursing care based on standard of practice. - Competent in performing nursing therapies & making clinical decisions about patients. - You are accountable for recognizing when nursing care is ineffective & you know the limits & scope of your practice.

Attitudes for Critical Thinking - Fairness

- Deal with situations justly. - Bias or prejudices do not enter into decision. - Look at situation objectively & consider all view-points to understand the situation completely before making a decision. - Imagine what it's like to be in your patient's position.

Attitudes for Critical Thinking - Risk Taking

- Desirable, particularly when the result is a positive outcome. - A critical thinker is willing to take risks in trying different ways to solve problems. - Willingness comes from experience with similar problems. Consider all options, follow safety guidelines, analyze potential dangers to a patient, & act in a well reasoned, logical, & thoughtful manner.

Attitudes for Critical Thinking - Perseverance

- Determined to find effective solutions to patient care problems. - Learn as much as possible about a problem & try various approaches to care. - Keep looking for resources until you find a successful approach. - Is not satisfied with a minimal effort, but work s to achieve the highest level of quality care.

Specific Critical Thinking - Diagnostic Reasoning & Inference

- Diagnostic Reasoning - analytical process for determining a patient's health problems; accurate recognition for a patient's problem is necessary before decide on solutions & implement action; requires you to assign meaning to behaviors & physical signs & symptoms presented; begins when you interact with a patient & make observations; helps healthcare providers pinpoint the nature of the problem more quickly & select proper therapies. - Inference - process of drawing conclusions from related pieces of evidence & previous experience with evidence; forming patterns of information from data before making a diagnosis; cannot make a precise diagnosis during your first meeting with a patient.

Developing of Critical Thinking - Meeting with Colleagues

- Discuss & examine work experiences. - Validates good practice & also offers challenges & constructive criticism. - Allows you to continually learn & develop your expertise & knowledge.

General Critical Thinking - Problem Solving

- Evaluating the solution over time to make that it is effective. - Necessary to try different options if a problem recurs. - Solving a problem in one situation adds to the nurse's experience in practice & allows the nurse to apply that knowledge in future patient situations.

Critical Thinking Model

- Explains what is involved as you make clinical decisions & judgements about your patients. - Defines outcomes of critical thinking & nursing judgement that is relevant to nursing problems in a variety of settings. - 5 Components - knowledge base, experience, critical thinking competencies, attitudes, & standards. - Combine to explain how nurses make safe, effective nursing care.

Attitudes for Critical Thinking - Creativity

- Find solutions outside of the standard routines of care while keeping standards of practice. - Motivates you to think of options & unique approaches.

Nursing Process as a Competency

- Five step clinical decision making approach. - Diagnose & treat human responses to actual or potential health problems. - Allows nurses to help patient's meet agreed on outcomes for better health. - Allows for flexibility for use in all clinical settings. - Identify patient needs by collecting thorough information & clearly defining all nursing diagnosis or collaborative problems. - Plan care by determining priorities, setting goals, & expected outcome of care, & collaborating with family & health care team. - Deliver interventions competently & evaluate the effects of your care.

General Critical Thinking - Decision Making

- Focuses on problem resolution. - Following a set of criteria helps to make a thorough & thoughtful decision. - May be personal, based on organizational policy, or a professional standard. - Define problem or situation & access all options. - Choosing which patient care priority requires first response, choosing a type of dressing, or selecting a teaching approach.

Attitudes for Critical Thinking - Confidence

- Grows with experience in recognizing your strengths & limitations. - Builds trust between you & your patients. - Feel certain when accomplishing a task or goal.

Standards of Critical Thinking - Intellectual Standards

- Guideline or principle for rational thought. - Apply these standards when using the nursing process. - Apply intellectual standards such as preciseness, accuracy, & consistency to make sure all clinical decisions are sound.

Clinical Decisions

- Judgement that includes critical & reflective thinking & action & application of scientific & practical logic. - Do not always have a clear picture of a patient's need & appropraite actions to take. - Learn to question, wonder, & explore different perspectives & interpretations to find a solution that benefits the patient. - Observe closely, gather information, examine ideas & inferences about problems, recognize the problems, consider scientific principles, & develop approach to nursing care.

Evidence Based Knowledge

- Knowledge based on research or clinical expertise. - Makes you an informed clinical thinker. - Thinking critically & learning about the concept prepares you the better anticipate your patient's needs.

Attitudes for Critical Thinking - Curiosity

- Learn a great deal of information about a patient. - Motivates you to inquire further & investigate a clinical situation, so you get all the information you need to make a decision.

Attitudes for Critical Thinking - Thinking Independently

- Learn to consider all sides of a situation. - Challenge the way others think & look for rational & logical answers to problems. - Important step in evidence-based practice. - Are essential to the improvement & expansion of nursing practice.

Critical Thinking - Thinking & Learning

- Learning is a lifelong process. - Intellectual & emotional growth involves learning new knowledge & refining your ability to think, problem solve, & make judgments. - Have to flexible & always open to new information. - Don't let thinking become routine or standardized. - With experience, you will be able to recognize patterns of behavior, see commonalities in signs & symptoms, & anticipate reactions to therapies.

Attitudes for Critical Thinking - Discipline

- Misses few details & follows an orderly or systematic approach when collecting information, making decisions, or taking action. - Helps identify problems more accurately & select the most appropriate interventions.

Critical Thinking Model - Experience

- Necessary to acquire clinical decision making skills. - With experience, you begin to understand clinical situations, recognize cues of patients' health patterns, & interpret cues as relevant or irrelevant. - Learn from observing, sensing, talking with patients & families, & reflecting actively.

Critical Thinking Model - Knowledge Base

- Prepares you to better anticipate & identify patient problems by understanding their origin & nature. - Continually changing as science progress. - Includes information & theory form the basic sciences, humanities, behavioral sciences, & nursing. - Think holistically about patient problems. - Depth & extent of knowledge influence your ability to think critically about nursing problems.

Specific Critical Thinking - Clinical Decision Making

- Problem solving activity that focuses on defining a problem & selecting an appropriate actions. - Nurse identifies a patient's problem & selects an intervention. - Requires careful reasoning. - Time, experience, & quality of relationships with patients allows nurses to know clinical situations & quickly anticipate & select right course of action. - Always keep the patient the center of focus. - Making an accurate clinical decision allows you to set priorities from the interventions to implement first.

Standards of Critical Thinking - Professional Standards

- Promote highest level of quality nursing care. - Requires you to use the critical thinking for good of individuals or groups. - Use ethical criteria for nursing judgements, evidence based criteria used for evaluation, & criteria for professional responsibility. - Guarantees quality health care to the public.

Attitudes for Critical Thinking - Integrity

- Question & test their own knowledge & belief. - Builds trust with coworkers. - Is honest & willing to admit mistakes or inconsistencies in his or her own behavior, ideas, & beliefs.

Developing Critical Thinking Skills - Reflective Journal

- The process of purposefully thinking back or recalling a situation to discover its purpose or meaning. - A conscious process of thinking, analyzing, & learning from your work situations by a way of journaling or regularly meeting with colleagues to explore work situations & self evaluate. - Gives you the opportunity to define & express the clinical experience in your own words. - Helps you to become aware of how you make clinical decisions.

Critical Thinking Competencies

- Used to make judgements about the clinical care of patients. - General & specific critical thinking. - General includes the scientific process, problem solving, & decision making. - Specific includes diagnostic reasoning, clinical inference, & clinical decision making.

General Critical Thinking - Scientific Meathod

- Way to solve problems using reasoning. - Systematic, ordered approach to gathering data & solving problems used by nurses. - Looks for the truth & verifies that a set of facts agrees with reality. - Has 5 Steps - Identifying the problem, collecting data, formulating a question or hypothesis, testing the question or hypothesis, evaluating the results of test or study.